Sonic Endovenous Catheter

ABSTRACT

A device and method to improve the ultrasound visibility of a catheter placed inside the body is described. The catheter is sonically vibrated by an external driver device that transmits the acoustic vibration down the catheter and inside the body. An ultrasound transducer is used to pick up the ultrasound vibrations directly or detects the sonic vibrations using a Doppler mode ultrasound machine.

RELATED APPLICATIONS

This Application is a divisional application of U.S. patent applicationSer. No. 11/928,624 filed Oct. 30, 2007, soon to be issued U.S. Pat. No.8,448,644, issue date May 28, 2013, entitled SONIC ENDOVENOUS CATHETER,Attorney Docket No. CTI-1201, which is a non-provisional application andrelated to now abandoned U.S. Provisional Patent Application Ser. No.60/864,101 filed Nov. 2, 2006 entitled SONIC ENDOVENOUS CATHETER,Attorney Docket No. CTI-1201-P, which are all incorporated herein byreference in their entirety, and claims any and all benefits to whichthey are entitled therefrom.

FIELD OF THE INVENTION

This device is related to imaging of catheter devices placed inside thebody for the diagnosis or treatment of internal diseases. This device isalso used to reduce the perceived pain of tumescent anesthesiainjections and to induce vein spasm when treating venous disease to helpdrain the vessel of blood.

BACKGROUND OF THE INVENTION

Ultrasound and ultrasonic imaging has made great advances in recentyears do to improved transducers, computer analysis of the return signaland the incorporation of Doppler analysis of the image. US equipment isstandard equipment in all hospitals and many clinics. The use ofultrasound is critical for locating catheters in veins duringendovascular procedures. In most cases the resolution and gain ofcurrent equipment is sufficient to see the catheter and interpret theimage, although it is common to use a specially trained technician tooperate the device because it does require training and skill that fewdoctors have. The Doppler mode on these ultrasound machines is typicallyused to show movement of blood in veins or arteries. The Dopplerfrequency shift of sound that reflects of moving objects is displayedwith a color on the ultrasound image that shows tissue or bloodmovement. The intensity and duration of this movement can be used todiagnose reflux in leg veins that are caused by incompetent valves andresult in varicose veins.

Doppler is also used to image blood flowing in the heart to showefficiency and functionality of heart valves. When the target structureis very deep in tissue as when imaging veins in the thigh, it can bevery hard to resolve the structure. In fact, imaging the end of thecatheter is considered to be one of the most difficult parts of anendovenous procedure such as varicose vein treatment. In many cases, ifthe catheter is not imaged properly it is possible to treat the wrongsection of the vein or even the wrong vein causing severe complicationsor even death. There is a great need to improve the ability to seeinside the body. It would be advantageous to enhance the visibility ofthe location of catheters.

In addition there is a need to drain blood and reduce the diameter ofvessels during endovenous ablation for the treatment of varicose veins.This can be accomplished by elevating the leg, applying compression, orinjecting vasoconstrictors near the vein. It is also possible to causethe vein to shrink in size and force out blood by stimulating the veinto react in a way that is called a “spasm”. This is a natural bodyreaction to insult or injury that helps protect the venous system.During some types of surgery, particularly endovenous ablation, it helpsto try to force the vein to spasm after the catheter is inserted soblood is forced out of the vein that may interfere with the ablationprocess. The prior art fails to teach a device that is able to vibrateinside the vein at about 500 Hz and tickling the entire internal lengthof the vein.

Pain management is a big part of the practice of many doctors,especially since more procedures are being done under local anesthesiain the doctor's office instead of in the hospital under generalanesthesia. With the patient awake, the practice of certain proceduresrequires different techniques to prevent the patient from perceivingpain. It has been known that it is possible to distract patients frompain sensations and to stimulate nerves with a secondary sensation thatblocks the transmission of a pain. Dentists commonly do this by pinchingthe cheek prior to injecting anesthesia and the vibrations from amotorized liposuction probe can mask the sensations of a needlepenetrating the skin The prior art fails to teach a way to do thisinside the body in previously inaccessible locations by transmitting thedistracting vibrations down a catheter or probe to the internaltreatment site.

Prior devices to enhance imaging of internal structures using soundenergy have concentrated on a couple of techniques:

1. Increasing the acoustic reflectivity of devices inserted into thebody.

2. Placing ultrasound transducers on the device inside the body anddetecting the emissions externally.

3. Transmitting longitudinal US waves down waveguides into the body anddetecting the return waves along the same waveguide.

One major disadvantage of prior art imaging systems is the very lowsignal to noise ration of the technology. When the device to be imagedhas an acoustic reflectivity that is close to that of the surroundingtissue it is very hard to get enough sound to bounce off of it to beimaged. This is especially true for small objects like a fiber opticcatheter.

The acoustic density of glass or metal is close enough to that of bloodor tissue that a piece of glass is very hard to image. In many casesintroducing air into the tip of the catheter is not feasible. Air totissue has a very large difference in acoustic density so that an airtissue interface reflects sound very well. Many prior art devices useair to enhance imaging.

ADVANTAGES AND SUMMARY OF THE INVENTION

The present invention improves the imaging of the position of devicesinside the body. The present invention uses an auxiliary sonic generatorto transmit a relatively low frequency acoustic energy at typically 100to 1000 Hz into the body. The present invention also transmits theenergy using transverse mechanical waves and not longitudinal soundwaves as all prior ultrasound techniques have utilized.

While devices of the prior art utilize ultrasound detectors to sense thehigh frequency vibrations directly, the present invention alters theultrasound detection by imposing a Doppler or frequency shift on thereturn ultrasound signal. It is this Doppler shifted signal which caneasily be imaged. No other parts of the body are moving this speed sothe contrast and signal to noise is very high on the imaging system.

In certain embodiments, the present invention may not allow preciseimaging of fine details on the internal device. It may only create areflecting surface that is moving rapidly enough to be detected under aDoppler imaging device. The main advantage of the present system is togenerate a locating signal that has a very high signal to noise ratio.The movement potentially blurs out the fine details that are less thanthe amplitude of the oscillation.

The present invention is a method to enhance visibility of a catheterdevice during an endovascular treatment. The method includes the stepsof vibrating a catheter device, cannula or probe and ultrasonicallyimaging the catheter device, a cannula, or probe.

The step of vibrating the catheter device, cannula or probe includesproviding a rotational, translational or longitudinal movement thereto.

In a method of sonic endovenous catheter of the present invention, thecatheter, cannula or probe is vibrated at a frequency of between about10 Hz and about 3000 Hz.

In a method of sonic endovenous catheter of the present invention, thecatheter, cannula or probe is vibrated at a frequency of between about100 Hz and about 1000 Hz.

In a method of sonic endovenous catheter of the present invention, thecatheter, cannula or probe is vibrated at a frequency of about 500 Hz.

In a method of sonic endovenous catheter of the present invention, thevibration frequency and intensity of vibration is adjusted and optimizedfor maximum visibility using Doppler capability of an ultrasound-imagingmachine.

The method of sonic endovenous catheter of the present invention furtherincludes the step of coupling the vibrating device catheter or probeoutside the body such that the vibrations are transmitted along thecatheter into the body.

In a method of sonic endovenous catheter of the present invention, thevibrating device is built into the catheter or probe and the vibratingis initiated from within the body.

The method of sonic endovenous catheter of the present invention furtherincludes the step of removably coupling the catheter to be vibrated to ahand-piece that incorporates the vibrator.

The present invention is also a method for inducing vein spasm. Themethod includes the step of vibrating a device inside a vein.

The present invention is also a method for forcing blood out of a veinduring endovascular treatment. The method includes the steps ofvibrating a catheter or probe inside a vein and inducing vein spasm,such that the vein spasm temporarily reduces the diameter of the vein.

The present invention is also a method for reducing pain. The methodincludes the step of vibrating a catheter, a cannula or other functionalprobe endoscopically placed inside a vein.

The method of sonic endovenous catheter of the present invention furtherincludes the step of timing the vibrations to distract the patient andoverwhelm the nerves in the area of treatment to reduce the sensation ofpain in the area of treatment.

The method of sonic endovenous catheter of the present invention furtherincludes the step timing the vibrations are timed to distract thepatient and overwhelm nerves in the area of treatment and injectinglocal anesthesia or tumescent anesthesia.

The present invention is also a method for reducing pain associated withthe endoscopic insertion and/or moving of a catheter, cannula or otherfunctional probe. The method includes the step of vibrating thecatheter, cannula or other functional probe placed inside a vein.

The present invention is also a system for enhancing an endoscopictherapeutic treatment. The system includes an endoscopic catheter,cannula or other functional probe having a predetermined length, avibration emitter for emitting transverse wave vibrations along thecatheter, cannula or other functional probe, apparatus for coupling thevibration emitter to the catheter, cannula or other functional probe,wherein transverse waves are transmitted along the length thereof.

In the sonic endovenous catheter system of the present invention, theamplitude of the vibrations emitted by the vibration emitter can beselected manually.

In the sonic endovenous catheter system of the present invention, theamplitude of the vibrations emitted by the vibration emitter can bepre-programmed.

In the sonic endovenous catheter system of the present invention, thefrequency of the vibrations emitted by the vibration emitter can beselected manually.

In the sonic endovenous catheter system of the present invention, thefrequency of the vibrations emitted by the vibration emitter can bepre-programmed.

In the sonic endovenous catheter system of the present invention, thevibration emitter operates at a rate of between about 10 and about 3000Hz.

In the sonic endovenous catheter system of the present invention, thevibration emitter operates at a rate of between about 100 and about 1000Hz.

In the sonic endovenous catheter system of the present invention, thevibration emitter operates at a rate of about 500 Hz.

In the sonic endovenous catheter system of the present invention, thevibration emitter comprises a motor selected from the group consistingof oscillating motors, rotary and other stepper motors, galvanometers,linear motors and out of balance or eccentrically weighted motors.

In the sonic endovenous catheter system of the present invention, thevibration emitter transmits linear motion to the catheter, cannula orother functional probe.

In the sonic endovenous catheter system of the present invention, thevibration emitter transmits rotational motion to the catheter, cannulaor other functional probe.

In the sonic endovenous catheter system of the present invention, thevibration emitter transmits sinusoidal motion to the catheter, cannulaor other functional probe.

In the sonic endovenous catheter system of the present invention, theendoscopic catheter, cannula or other functional probe comprises anoptical fiber having a diameter between about 100 um and about 1000 um.

Further details, objects and advantages of the present invention will become apparent through the following descriptions, and will be includedand incorporated herein.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a representative drawing of an oscillating motorized device100 clipped to a catheter 200 to produce rotational vibrations andtransverse waves 110 in the catheter 200 according to the devices andmethods of the present invention.

FIG. 2 is a representative drawing of the catheter 200 image on anultrasound machine with and without vibrations 110 according to thedevices and methods of the present invention.

FIG. 3 are a representative drawings of the end view 152 of themotorized vibrating device 100 showing the clip 150 to the catheter 200and three possible motions that will cause the entire catheter 200 tovibrate according to the devices and methods of the present invention.

FIG. 4 are representative drawings showing how three vibrationgenerators 100 can work using a rotary stepper motor, a galvanometer, alinear motor and an out of balance weight according to the devices andmethods of the present invention.

FIG. 5 is a representative top view of one embodiment of steriledisposable clip 150 according to the devices and methods of the presentinvention.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT

The description that follows is presented to enable one skilled in theart to make and use the present invention, and is provided in thecontext of a particular application and its requirements. Variousmodifications to the disclosed embodiments will be apparent to thoseskilled in the art, and the general principals discussed below may beapplied to other embodiments and applications without departing from thescope and spirit of the invention. Therefore, the invention is notintended to be limited to the embodiments disclosed, but the inventionis to be given the largest possible scope which is consistent with theprincipals and features described herein.

It will be understood that in the event parts of different embodimentshave similar functions or uses, they may have been given similar oridentical reference numerals and descriptions. It will be understoodthat such duplication of reference numerals is intended solely forefficiency and ease of understanding the present invention, and are notto be construed as limiting in any way, or as implying that the variousembodiments themselves are identical.

FIG. 1 is a representative drawing of an oscillating motorized device100 clipped to a catheter 200 to produce rotational vibrations andtransverse waves 110 in the catheter 200 according to the devices andmethods of the present invention. FIG. 2 is a representative drawing ofthe catheter 200 image on an ultrasound machine with and withoutvibrations or transverse waves 110 according to the devices and methodsof the present invention.

Apparatus:

As best shown in FIG. 1 and FIG. 2, an embodiment of the presentinvention requires three parts:

-   -   1. A catheter 200 or probe that is rigid and strong enough to        vibrate in a transverse manner without degrading.    -   2. A mechanical vibrating device 100 that moves the proximal end        of the catheter a sufficient distance to generate vibrations or        transverse waves 110 that propagate the length of the catheter        200.    -   3. An ultrasound-imaging machine 300 that has a Doppler mode to        view the moving catheter 200 inside the body.

In one embodiment, catheter 200 can be an electrical wire assembly thatis used to transmit electrical or radio frequency current. Theconstruction can use fine wires that are flexible enough to withstandrepeated vibrations without breaking. In alternative embodiments,catheter 200 can also be made of optical quartz, silica or othertransparent materials. In one embodiment, catheter 200 should be thinenough to vibrate readily without causing internal bending stresses andshould have protective jacket material over the silica to add strength.Many fiber optic catheters 200 used to deliver laser energy areconstructed in a manner that will survive such mechanical vibrations110.

The probe can also be a hollow cannula such as a long needle or tube ora rigid shaft or mechanical device such as used for obtaining biopsysamples.

FIGS. 3 a, 3 b, 3 c and 3 d are representative drawings of the end view152 of the motorized vibrating device 100 showing the clip 150 to thecatheter 200 and three possible motions that will cause the entirecatheter 200 to vibrate according to the devices and methods of thepresent invention. FIG. 4 are representative drawings showing how threevibration generators 100 can work using a rotary stepper motor, agalvanometer, a linear motor and an out of balance weight according tothe devices and methods of the present invention.

FIG. 5 is a representative top view of one embodiment of steriledisposable clip 150 according to the devices and methods of the presentinvention. Sterile disposable clip 150 has a proximal end 156 whichcouples to the oscillating motor 100, and a distal end groove 154 whichclips the distal end 152 of the sterile disposable tip 150 to thecatheter 200. In one embodiment, sterile disposable clip 150 further hasone or more finger grip(s) 158 for conveniently connecting steriledisposable clip 150 to oscillating motor 100.

A transverse wave 110 is one in which the direction of displacement ateach point of the medium is parallel to the wavefront, or a wave inwhich the vibration is moving in a direction perpendicular as that inwhich the wave is traveling. In a transverse wave the medium moves atright angles to the wave direction. For example: if a wave moves alongthe x-axis, its oscillations are in the y-z plane. In other words, itoscillates across the 2-dimensional plane that it is traveling in. Itmay oscillate either vertically or horizontally, and this refers to itspolarity. Water waves are an example of transverse waves.Electromagnetic waves are also transverse waves.

As best shown in FIG. 3 and FIG. 4, the mechanical vibrating device 100can operate in several modes to generate transverse wave motion 110 inthe catheter 200. As best shown in FIG. 3 b and FIG. 4 a, in oneembodiment, a rotary motion E can be used to twist the catheter 200 backand forth through about plus or minus 15 degrees. In one embodiment, arotary motion E can be generated by a stepper motor 102 such asavailable from AMCI or Danaher Motion which is stepped back and forththrough one step. An electronic galvanometer such as available fromGeneral Scanning can be used which has a shaft that is connected toelectromagnets in a coil. When alternating current is applied to thecoils the shaft will oscillate through a small angle in either a drivenor a resonant fashion. A stepper motor 102, where an internal rotorcontaining permanent magnets is controlled by a set of external magnetsthat are switched electronically. A stepper motor 102 is a cross betweena DC electric motor and a solenoid. A stepper motor 102 is a type ofelectric motor which is used when something has to be positioned veryprecisely or rotated by an exact angle. Simple stepper motors 102 “cog”to a limited number of positions, but proportionally controlled steppermotors can rotate extremely smoothly. Computer controlled stepper motors102 are one of the most versatile forms of positioning systems,particularly when part of a digital servo-controlled system. In astepper motor 102, an internal rotor containing permanent magnets iscontrolled by a set of stationary electromagnets that are switchedelectronically. Hence, it is a cross between a DC electric motor and asolenoid. Stepper motors 102 do not use brushes and commutators. Steppermotors 102 have a fixed number of magnetic poles that determine thenumber of steps per revolution. Most common stepper motors 102 have 200full steps/revolution, meaning it takes 200 full steps to turn onerevolution. Advanced stepper motor 102 controllers can utilizepulse-width modulation to perform microsteps, achieving higher positionresolution and smoother operation. Some microstepping controllers canincrease the step resolution from 200 steps/rev to 50,000microsteps/rev. Stepper motors 102 are rated by the torque they produce.A unique feature of steppers is their ability to provide positionholding torque while not in motion. To achieve full rated torque, thecoils in a stepper motor 102 must reach their full rated current duringeach step. Stepper motor 102 drivers must employ current regulatingcircuits to realize this. The voltage rating (if there is one) is almostmeaningless. Computer controlled stepper motors 102 are one of the mostversatile forms of positioning systems, particularly when digitallycontrolled as part of a servo system.

In an alternative embodiment, as best shown in FIG. 4 b, a linear motionF can be produced by a linear motor 104. A linear motor 104 isessentially an electric motor that has been “unrolled” so that insteadof producing a torque (rotation), it produces a linear force along itslength by setting up a traveling electromagnetic field. Linear motors104 are most commonly induction motors or stepper motors. You can find alinear motor in a maglev (Transrapid) train, where the train “flies”over the ground.

In yet another alternative embodiment, as best shown in FIGS. 3 c and 4c, a up and down motion G can be produced by an out of balance arc motor106.

Methods of Use:

FIG. 2 is a representative drawing of the catheter 200 image on anultrasound machine with and without vibrations 110 according to thedevices and methods of the present invention. An embodiment of animaging procedure is as follows:

-   -   1. The Ultrasound Imaging device such as made by GE, or others        is placed over the section of body of interest. For example, in        the case of performing endovascular laser ablation to treat        varicose veins, the transducer head of the ultrasound device        could be placed to image the saphenofemoral junction (SFJ).    -   2. Insert the catheter 200 into the vein from an access point        near the knee and move it toward the SFJ. It is critical that        the ablation catheter 200 be placed precisely 1-2 cm below this        junction or damage to femoral vein could occur with severe        consequences to the patient. Using conventional passive        ultrasound, it is usually very hard to see the image of the        catheter 202 or the catheter tip 204 at this site as best shown        in FIG. 2( a).    -   3. Attach the external sonic vibrator device 100 described above        to the catheter 200 just outside the access point to the vein,        and turn on to vibrate the catheter 200 in a transverse manner        down through the vein to the tip. Switch the ultrasound-imaging        machine to Doppler mode, as best shown in FIG. 2( b), and look        for the characteristic color pattern 206 created by moving        objects. Move the catheter 200 slowly in and out until the color        pattern is properly positioned.    -   4. The intensity of the color Doppler pattern 206 may be        adjusted by changing the external vibration 110 frequency or        intensity. It is advantageous to not overwhelm the image of the        vein at the same time but to adjust the signal strength so that        the tip of the catheter 208 and the vein are both visible at the        same time.

Experimental Results:

A branched vessel phantom made by Advanced Medical Technologies, SelectSeries Branched 4 Vessel Vascular Access Phantom by Blue Phantom PN BPBV110, filled with water was used to simulate a vein inside the body. A600 um endovenous ablation catheter was placed in one of the vein lumensthrough a silicone tube to simulate vein transmission. A DiasonicsSpectra Plus ultrasound-imaging machine with a 5 MHz linear arraycoupled with gel was used to image the catheter in the phantom. Afterthe vein was located in the phantom under ultrasound, the catheter wasinserted to the desired location. The gain on the ultrasound was reduceduntil the catheter was no longer visible to simulate imaging deep withinthe body. An oscillating motor was attached to the catheter about 24inches from the imaging site. The motor rotated through 30 degrees ofmovement at about 500 Hz causing the catheter to vibrate in largestanding waves that had about 5 mm of amplitude outside the phantom.Inside the phantom it was estimated that the catheter movedapproximately 1 mm in a transverse vibration. Under ultrasound with theDoppler mode, this movement was seen as a large colored area that had adistinct end point to it. After the gain of the ultrasound was reduced,it was possible to see exactly where the catheter was located. The endof the catheter signal moved in and out clearly with catheter movementfrom outside.

Subsequently, the catheter was “life tested” to determine the fatiguethat the vibrations may impose on the catheter. The catheter, a 600 umquartz endovenous probe, was vibrated for an additional one hour withoutany signs of degradation. The vibration time in vivo should be a minuteor less. The simulated life test was considered successful, and furthertesting will determine mean time before failure, usable life expectancy,etc. Tests also show that the 365 um fiber works better inside the legthan the thicker 600 um fiber.

Guideline for the Use of Sonic Vibrator

Pre Operation:

1. Make sure that handle is charged. A full charge will last for about30 mm of use as indicated by 3 or more green leds on the handle.

2. Sterilize fiber clip by autoclaving in pouch for 270 degrees F. for 3mm or 250 deg F. for 15 mm.

Sterile Field:

1. Place sonic handle in sterile Ultrasound probe bag.

2. Place fiber clip onto handle through sterile bag. Make sure that itis tight onto handle.

3. Advance fiber through sheath in vein until it is approximately at theproper place.

4. Set Ultra Sound to doppler mode and image the location.

5. Choose a location on the fiber about 2 inches outside sheath to placethe sonic vibrator.

6. Slide the fiber into the slot at the end of fiber clip making surethat it is fully engaged and tight in the slot.

7. Press light green “ON” button on the sonic handle to vibrate fiber.It may be necessary to tape or hold the free side of the fiber toprevent it from vibrating excessively outside the leg. The fiber shouldstay attached in the slot in the fiber clip. If it falls out, push itback in.

8. The sonic handle may turn off by itself in about 1 minute. Simplypress the light green button to re start it. The handle may also pauseoccasionally but re-start by itself.

9. Locate the end of the fiber by locating the color pattern generatedby the Doppler image. Turn down the gain of the US if necessary to getbetter resolution. The tip of the fiber should show as a clean end tothe color return. Move the fiber in or out of the sheath to position thefiber in the vein.

10. Turn the sonic handle off by pressing the light green button againand remove the fiber from the holder.

11. Slip a white donut marker over the fiber at the end of the sheath tomark the fiber position.

12. Proceed with the endovenous ablation.

13. The fiber clip may be reused.

Unless defined otherwise, all technical and scientific terms used hereinhave the same meaning as commonly understood by one of ordinary skill inthe art to which the present invention belongs. Although any methods andmaterials similar or equivalent to those described can be used in thepractice or testing of the present invention, the preferred methods andmaterials are now described. All publications and patent documentsreferenced in the present invention are incorporated herein byreference.

While the principles of the invention have been made clear inillustrative embodiments, there will be immediately obvious to thoseskilled in the art many modifications of structure, arrangement,proportions, the elements, materials, and components used in thepractice of the invention, and otherwise, which are particularly adaptedto specific environments and operative requirements without departingfrom those principles. The appended claims are intended to cover andembrace any and all such modifications, with the limits only of the truepurview, spirit and scope of the invention.

We claim:
 1. A method to enhance visibility of a catheter device duringan endovascular treatment, the method comprising: vibrating a catheterdevice, cannula or probe; and ultrasonically imaging the catheterdevice, cannula or probe.
 2. The method of claim 1 in which the step ofvibrating the catheter device, cannula or probe comprises providing arotational, translational or longitudinal movement thereto.
 3. Themethod of claim 1 in which the catheter, cannula or probe is vibrated ata frequency of between about 10 Hz and about 3000 Hz.
 4. The method ofclaim 1 in which the catheter, cannula or probe is vibrated at afrequency of between about 100 Hz and about 1000 Hz.
 5. The method ofclaim 1 in which the catheter, cannula or probe is vibrated at afrequency of about 500 Hz.
 6. The method of claim 1 in which thevibration frequency and intensity of vibration is adjusted and optimizedfor maximum visibility using Doppler capability of an ultrasonic-imagingmachine.
 7. The method of claim 1 further comprising the step ofcoupling the vibrating device catheter or probe outside the body suchthat the vibrations are transmitted along the catheter into the body. 8.The method of claim 1 in which the vibrating device is built into thecatheter or probe and the vibrating is initiated from within the body.9. The method of claim 1 further comprising the step of removablycoupling the catheter to be vibrated to a handpiece that incorporatesthe vibrator.
 10. A method performing a medical treatment inside a bodylumen or cavity under visualization comprising: introducing a catheterdevice, cannula or other functional probe into a body lumen or cavity;vibrating the catheter device, cannula or other functional probe; andultrasonically imaging the catheter device, cannula or other functionalprobe.
 11. The method of claim 10 further comprising: coupling avibration emitter to the catheter device, cannula or other functionalprobe, said vibration emitter selected from the group consisting ofoscillating motors, rotary and other stepper motors, galvanometers,linear motors and out of balance or eccentrically weighted motors.
 12. Amethod to enhance visibility of a catheter device, cannula or otherfunctional probe while performing endovascular treatment comprising:introducing an endoscopic catheter, cannula or other functional probehaving a tip and a length into a vein, wherein the endoscopic catheter,cannula, or other functional probe comprises an optical fiber; couplinga vibration emitter to the catheter, cannula or other functional probe;using the vibration emitter to vibrate the catheter, cannula, or otherfunctional probe such that transverse wave vibrations are generatedalong the catheter, cannula, or other functional probe that propagatethe length of the catheter, cannula, or other functional probe at anadjustable frequency of between 10 and 3000 Hz inside the vein;visualizing the tip of the endoscopic catheter, cannula or otherfunctional probe.
 13. The method of claim 12 further comprising:manually selecting an amplitude of the wave vibrations generated by thevibration emitter.
 14. The method of claim 12 further comprising:manually selecting the adjustable frequency of the wave vibrationsgenerated by the vibration emitter.
 15. The method of claim 12 furthercomprising: selecting the vibration emitter from the group consisting ofoscillating motors, rotary and other stepper motors, galvanometers,linear motors and out of balance or eccentrically weighted motors. 16.The method of claim 12 wherein the optical fiber has a diameter between100 μm and 1000 μm.
 17. The method of claim 12 further comprising:delivering laser energy from the catheter, cannula, or other functionalprobe to the vein.
 18. The method of claim 12 further comprising:visualizing the tip of the catheter, cannula or other functional probeusing Doppler shifted ultrasound imaging.
 19. The method of claim 12further comprising: vibrating a catheter device, cannula or otherfunctional probe, and ultrasonically imaging the catheter device,cannula or other functional probe by imposing a Doppler or equivalentfrequency shift on the return ultrasound signal.